AIM:To assess early visual outcomes and corneal stability following small incision lenticule extraction(SMILE)in eyes with a pre-planned residual stromal thickness(RST)ranging from 280 to 300μm.METHODS:This retrospec...AIM:To assess early visual outcomes and corneal stability following small incision lenticule extraction(SMILE)in eyes with a pre-planned residual stromal thickness(RST)ranging from 280 to 300μm.METHODS:This retrospective study was designed to evaluate 82 eyes from 82 patients,all of whom had a pre-planned RST of 280 to 300μm and normal corneal topography prior to undergoing SMILE surgery.The mean preoperative spherical equivalent(SE)was-4.82±1.30 D.A standard follow-up protocol was conducted between 1 to 6mo postoperatively.Visual outcomes were recorded using uncorrected visual acuity(UCVA)and subjective refraction.The curvature of the anterior and posterior corneal surfaces,as well as the posterior elevation at the thinnest point(PTE)were derived from the Pentacam system.RESULTS:At the final follow-up,the efficacy index was 1.14±0.15,the safety index was 1.20±0.13.The mean preoperative UDVA was 0.78±0.16 logMAR,which improved significantly to-0.07±0.06 logMAR postoperatively(P<0.001).The preoperative mean SE was-4.82±1.30 D,which decreased to-0.14±0.30 D by the last visit.The curvature of the anterior cornea at the flat meridian(AK1)were 42.62±1.02 D preoperatively,38.56±1.37 D and 38.59±1.39 D at 1 and 6mo after operation,respectively.Corresponding measurements at the steep meridian(AK2)were 43.55±1.14 D preoperatively,39.18±1.46 D and 39.22±1.50 D at 1 and 6mo after operation,respectively.Both AK1 and AK2 remained stable at 1 and 6-mo postoperative intervals(P=0.126 and 0.082,respectively).There were no observed changes in the curvature of the posterior cornea at the flat meridian or at the steep meridian,or the PTE before and after surgery.CONCLUSION:SMILE represents a safe and effective procedure for the correction of myopia and astigmatism in eyes featuring a pre-planned RST ranging from 280 to 300μm accompanied by normal corneal topography,on the premise of strict control of surgical indications.展开更多
AIM:To compare and evaluate the phacoemulsification parameters and postoperative endothelial cell changes of two different phacoemulsification machines, each with different modes, but also to assess the relationship b...AIM:To compare and evaluate the phacoemulsification parameters and postoperative endothelial cell changes of two different phacoemulsification machines, each with different modes, but also to assess the relationship between postoperative endothelial cell loss and the phacoemulsification parameters, as well as the other factors in both groups.METHODS:This prospective observational study was comprised of consecutive eligible cataract patients operated with phacoemulsification technique performed by the same surgeon using either a WHITESTAR Signature Ellips FX(transversal, group 1) or Infiniti OZil IP(torsional, group 2) machine.RESULTS:The study included 86 patients. Baseline characteristics in the groups were similar. The median nuclear sclerosis grade was 3(2-4) in the first group and2(2-4) in the second group(P =0.265). Both groups had similar phacoemulsification needle times(group 1: 60.63±36 s; group 2: 55.98±30 s; P =0.789). The percentage of endothelial cell loss 30 d after surgery ranged from 3% to15% with a median of 7% in group 1, and from 2% to13% with a median of 6% in group 2; however, there was no statistically significant difference between the groups(P =0.407). Hexagonality(P =0.794) and the coefficient of variation(CV; P =0.142) did not differ significantly between the groups before and 30 d after surgery. Asignificant positive correlation was found between the endothelial cell loss and nuclear sclerosis grade(group1: P 【0.001; group 2: P 【0.001) and between the endothelial cell loss and average phacoemulsification power(group 1: P =0.007; group 2: P =0.008).CONCLUSION:Both of these machines were efficient,with similar endothelial cell loss. This endothelial cell loss was related to the increased nuclear sclerosis grade and increased phacoemulsification power.展开更多
AIM： To collect the evidence to estimate the correlation between smoking and the incidence of dry eye. METHODS： The Pub Med,EMBASE,the Cochrane Central Register of Controlled Trials（CENTRAL,last issue）,CBM（Chines...AIM： To collect the evidence to estimate the correlation between smoking and the incidence of dry eye. METHODS： The Pub Med,EMBASE,the Cochrane Central Register of Controlled Trials（CENTRAL,last issue）,CBM（Chinese Bio Medical Literature Database）,and CNKI（China National Knowledge Infrastructure/Chinese Academic Journals full-text Database） were searched for eligible studies published from January1964 to December 2015 to investigate the association of smoking with the risk of dry eye.The odds ratio（OR）and 95% confidence interval（CI） were summarized and calculated.The extracted studies were pooled by the fixed-effects model or a random-effects model. RESULTS： Two cohort studies and eight cross-sectional surveys were included in our Meta-analysis.There was no statistically significant relationship between current（OR=1.32; 95% CI： 0.99-1.76; P=0.055）or ever smoking（OR=1.12; 95% CI： 0.98-1.28; P=0.107）and the risk of dry eye among the studies,even when age and gender were adjusted（OR=1.16; 95% CI： 0.83-1.64; P=0.383）.In the sensitivity analysis in which only general population were included,the association was significant between smoking and dry eye（OR=1.50; 95%CI： 1.08-2.09; P=0.016）.CONCLUSION： This Meta-analysis suggests that smoking may associate with the risk of dry eye in general population.展开更多
AIM:To characterize the N6-methyladenosine(m6A)modification patterns in long non-coding RNAs(lncRNAs)in sporadic congenital cataract(CC)and age-related cataract(ARC).METHODS:Anterior capsule of the lens were collected...AIM:To characterize the N6-methyladenosine(m6A)modification patterns in long non-coding RNAs(lncRNAs)in sporadic congenital cataract(CC)and age-related cataract(ARC).METHODS:Anterior capsule of the lens were collected from patients with CC and ARC.Methylated RNA immunoprecipitation with next-generation sequencing and RNA sequencing were performed to identify m6A-tagged lncRNAs and lncRNAs expression.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses and Gene Ontology annotation were used to predict potential functions of the m6A-lncRNAs.RESULTS:Large amount of m6A peaks within lncRNA were identified for both CC and ARC,while the level was much higher in ARC(49870 peaks)than that in CC(18688 peaks),yet those difference between ARC in younger age group(ARC-1)and ARC in elder age group(ARC-2)was quite slight.A total of 1305 hypermethylated and 1178 hypomethylated lncRNAs,as well as 182 differential expressed lncRNAs were exhibited in ARC compared with CC.On the other hand,5893 hypermethylated and 5213 hypomethylated lncRNAs,as well as 155 significantly altered lncRNA were identified in ARC-2 compared with ARC-1.Altered lncRNAs in ARC were mainly associated with the organization and biogenesis of intracellular organelles,as well as nucleotide excision repair.CONCLUSION:Our results for the first time present an overview of the m6A methylomes of lncRNA in CC and ARC,providing a solid basis and uncovering a new insight to reveal the potential pathogenic mechanism of CC and ARC.展开更多
AIM: To investigate changes in the rabbit retina after shortterm and small amounts tamponade of perfluorooctane(PFO).METHODS: New Zealand rabbits were used, and 48 eyes were randomly and evenly assigned into four diff...AIM: To investigate changes in the rabbit retina after shortterm and small amounts tamponade of perfluorooctane(PFO).METHODS: New Zealand rabbits were used, and 48 eyes were randomly and evenly assigned into four different groups. The PFO groups received a residue of 0.1 mL of PFO for ophthalmic surgery or 0.1 mL of F-Octane at the end of surgery; eyes from the pars plana vitrectomy(PPV) group were filled with balanced salt solution and those having not received surgical intervention served as controls. Eyes were collected at 1, 4 and 12 wk and studied.RESULTS: Under a microscope, nuclear counts of the inner nuclear layer(INL) and outer nuclear layer(ONL) did not differ among the four groups at all time points; however, slight disarrangement of the ONL and occasional vacuolization of the INL were found in the inferior retina only at 12 wk in two PFO groups. Four of the groups had similar results of Caspase-3 and TNF-α staining at all time points. Alternatively, IL-8 was increased in PFOa and PPV control groups at 4 wk and in all three PPV groups at 12 wk; also, the apoptotic index(%) was similarly increased in all three PPV groups at 4 and 12 wk.CONCLUSION: Both PFOs are well tolerated in rabbit eyes for up to 12 wk, which suggests that they can be used safely as intraoperative tools or for short-term and small amounts tamponade after surgery.展开更多
AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHO...AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHODS:Demographic characteristics,cycloplegic refraction data,and ocular parameters of the participants were collected.Changes in ocular parameters were described according to different age groups.After adjusting for refractive factors,the relationship between age and ocular parameters was explored.Standard regression coefficients(β)obtained from multiple linear regressions were used to compare the magnitude of the effect of age on the parameters and ocular components on refractive power.RESULTS:Data were collected from the right eyes of 1504 participants.Lens thickness(LT)decreased with age,whereas the axial length(AL)and anterior chamber depth(ACD)increased.In the high-hyperopia group,changes in age were only associated with AL and LT.In the low-myopia group,the increase in age was also associated with corneal astigmatism.In the overall model,theβvalue for LT was the highest at 0.41,whereasβfor ACD and AL was significant in all groups except for the high-hyperopia group.Theβvalue of the LT on refractive power in children was slightly greater in the low age group than in the high age group.CONCLUSION:Among children with the same refractive status,the older the age,the longer the axis length and the thinner the lens.The lens affected refractive power in children in the younger age group more than in the older age group.The ocular parameter most affected by age was LT.展开更多
AIM: To evaluate the efficacy of a registration system for the blind people and to monitor the blindness due to uncorrected refractive error and cataract in Jing’an district, Shanghai, China. ·METHODS: Five hund...AIM: To evaluate the efficacy of a registration system for the blind people and to monitor the blindness due to uncorrected refractive error and cataract in Jing’an district, Shanghai, China. ·METHODS: Five hundred and ten blind people, based on visual acuity screening in a population aged 70 or older were enrolled into the study. Four hundred and forty subjects were interviewed. The following data were collected on each patient: demographic data, number of hospital visits for eye related problems, distance visual acuity, visual fields, ophthalmic diagnoses, education and registration status. If the eligible subject was not registered as blind, the reason for non -registration was recorded. ·RESULTS: Ten point nine one percent blindness was due to cataract, 27.5% due to uncorrected refractive error, and only 61.59% met the eligible blindness criteria (uncorrected refractive error and cataract are not considered as eligible blindness). The first four leading causes of eligible blindness were age related macular degeneration (25.09% ), myopic macular degeneration (21.40%), glaucoma (18.82%) and corneal disease (8.12%). Only 68.27% eligible blind people were registered. The patients with macular degeneration and glaucoma tendednot to register. Blind people with an above primary school education were 2.59 times more likely to be registered than those who were illiterate or had only a primary school education (OR=2.59, 95%CI: 1.49-4.48, P 【0.01). Patients who had 4 or more visits to the hospital requesting eye care services in a year were 2.2 times more likely to be registered than those with less than 4 visits to the hospital (OR =2.54, 95% CI: 1.47 -4.38, P 【 0.001). The first two leading reasons of misregistration were unknowing the registration system (48% ) and unwilling to register (21%). ·CONCLUSION: Under-registration of the eligible blind people exists in the registry system. Education and the number of hospital visits for eye care services were factors associated with registration levels. Uncorrected refractive error and cataract are important causes of blindness.展开更多
Univocal identification of retinal ganglion cells(RGCs) is an essential prerequisite for studying their degeneration and neuroprotection. Before the advent of phenotypic markers, RGCs were normally identified using re...Univocal identification of retinal ganglion cells(RGCs) is an essential prerequisite for studying their degeneration and neuroprotection. Before the advent of phenotypic markers, RGCs were normally identified using retrograde tracing of retinorecipient areas. This is an invasive technique, and its use is precluded in higher mammals such as monkeys. In the past decade, several RGC markers have been described. Here, we reviewed and analyzed the specificity of nine markers used to identify all or most RGCs, i.e., pan-RGC markers, in rats, mice, and macaques. The best markers in the three species in terms of specificity, proportion of RGCs labeled, and indicators of viability were BRN3A, expressed by vision-forming RGCs, and RBPMS, expressed by vision-and non-vision-forming RGCs. NEUN, often used to identify RGCs, was expressed by non-RGCs in the ganglion cell layer, and therefore was not RGC-specific. γ-SYN, TUJ1, and NF-L labeled the RGC axons, which impaired the detection of their somas in the central retina but would be good for studying RGC morphology. In rats, TUJ1 and NF-L were also expressed by non-RGCs. BM88, ERRβ,and PGP9.5 are rarely used as markers, but they identified most RGCs in the rats and macaques and ERRβ in mice. However, PGP9.5 was also expressed by non-RGCs in rats and macaques and BM88 and ERRβ were not suitable markers of viability.展开更多
AIM： To evaluate human lens epithelium cell apoptosis and epithelial to mesenchymal transition （EMT） induced by femtosecond laser in femtosecond laser assisted cataract surgery （FLACS）. METHODS： Sixty cataract ...AIM： To evaluate human lens epithelium cell apoptosis and epithelial to mesenchymal transition （EMT） induced by femtosecond laser in femtosecond laser assisted cataract surgery （FLACS）. METHODS： Sixty cataract patients with N2 to N3 stage according to the LOCS III were enrolled in this study and divided into three groups randomly： FLACSl group （cataract surgery by FLACS with LenSx）, FLACS2 group （cataract surgery by FLACS with LensAR） and manual group （cataract surgery by phacoemulsification）. Patients in two FLACS groups performed anterior capsulotomy by LenSx or LensAR laser system. Patients in the manual group were performed continuous curvilinear capsulorrhexis （CCC） manually. The anterior capsules were fixed right after moved out of eye. Hematoxylin-eosine staining, immunofluorescence staining and real-time PCR were performed in order to observe human lens epithelium cells changes after cataract surgery. RESULTS： The capsule cutting edge was shown irregularity and roughness in two FLACS groups and smooth edge in manual capsulotomy by pathologic staining. Irregularities of the cell configuration with partly swollen and destroyed nuclei were observed in two FLACS groups. Femtosecond laser could induce a significantly higher cell apoptosis in human lens epithelium cell than manually performed CCC （P〈0.05）. Lens epithelium cells apoptosis were correlated with femtosecond laser duration according to Pearson correlation analysis. Decreased N-cadherin expression, alpha-SMA and FSP-1 level in two FLACS groups showed the inhibition of cell EMT. CONCLUSION： Femtosecond laser may affect the apoptosis and EMT of lens epithelium cells which are under the peeled central lens capsule.展开更多
AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazoli...AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazolin hydrochloride(NH)group(14 animals,14 eyes)and control group(14 animals,14 eyes).In CFA group,CFA was used in eyelid conjunctiva injection;in NH group,NH eye drops were used twice a day;control group was injected with equal dose of saline at the same time point and same site with animals in CFA group.The meibomian gland orifices score(MGOS)was evaluated on a scale of 0 to 3 in the middle five meibomian gland orifices of the upper and lower eyelid using slit lamp.After the successful induction of each animal model,intense pulsed light(IPL)was introduced on each mouse in CFA and NH group.Oil red O(ORO),hematoxylin and eosin(H&E)staining were performed before and after successful induction of CFA,NH and control group.RESULTS:At 12wk after CFA injection,inflammatory cell infiltration and fiber necrosis was observed,with acinar density and duct dilatation significantly lower compared with control group.In NH group,the meibomian gland acini were relatively smaller and deformed compared with control group,the number of meibomian gland acini was also slightly lower.No inflammatory cell or fiber necrosis was observed in NH group.After three times of IPL treatment(5/10 mice in each group,and the other 5 mice served as non-IPL control),MGOS was significantly lower in IPL-treated mice in NH group(P<0.01).After three times of IPL treatment,the MGOS of NH group was significantly lower than that in the CFA group(P<0.01).CONCLUSION:We develop a novel animal model that studies the role of inflammation in the development of MGD and IPL treatment.This model indicates that persistent inflammatory state may be the cause of MGD and weaken the therapeutic effect of IPL.展开更多
AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The rel...AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.展开更多
AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coheren...AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coherence tomography in healthy Chinese adults. The horizontal scan of the right eye was used to measure the anterior chamber depth(ACD) at 199 points.RESULTS: A total of 309 images from 309 subjects were analyzed. The ACD values at nearly all locations were negatively correlated with age(all P<0.05), except for ACD1, 2, 198, and 199(correspond to the iris roots). The mean annual decrease 0.013±0.005 mm/y for all ACDs combined, 0.008±0.004 mm/y for the peripheral region, 0.017±0.003 mm/y for the middle peripheral region, and 0.014±0.001 mm/y for the central region. The mean annual decrease was significantly different among these three regions(P<0.001). The ACD was greater in males than in females(P<0.05). The mean difference in ACD between males and females was 0.081±0.025 mm.CONCLUSION: This study showed that optical coherence tomography can be used to measure the ACD of different regions of the AC. We found reductions in ACD with age, although the reduction varied among different points, in healthy Chinese adults.展开更多
Background:Esotropia is a common concern in pediatric ophthalmology consultations.While most cases stem from strabismus,it is crucial for physicians to differentiate atypical features that might indicate underlying or...Background:Esotropia is a common concern in pediatric ophthalmology consultations.While most cases stem from strabismus,it is crucial for physicians to differentiate atypical features that might indicate underlying organic causes,such as VI nerve palsy,hinting at the presence of intracranial spaceoccupying lesions.Although the occurrence of cerebral aneurysms in children is rare,they can have severe consequences.Case Description:Here,we described an extremely rare case of giant basilar fusiform aneurysm measuring 4.0 cm×3.9 cm×3.9 cm in an otherwise healthy 8-year-old child,and analyzed its atypical features that suggested an intracranial etiology.We further described an endovascular approach,performed by interventional radiologists,and discussed its advantages over the conventional neurosurgery.The patient continued to be followed by our multidisciplinary team.He had a stable post-operative course and made an excellent recovery neurologically.At the 1-year follow-up,he was orthophoria with excellent vision and stereopsis.Conclusions:To our knowledge,this is the first pediatric case in Canada where a giant intracranial aneurysm was treated endovascularly.The salient red flags—progressive incomitant esotropia and diplopia,the presence of myopia(rather than hyperopia),nystagmus and abnormal saccadic movements—should be astutely recognized by clinicians as intracranial giant aneurysms carry a poor prognosis.A multidisciplinary approach is essential for the management of such cases.展开更多
Background:Retinopathy of prematurity(ROP)is a disorder of retinal development in the low birthweight preterm infant.Eye screening is routinely performed for infants at risk of developing this disorder.While these exa...Background:Retinopathy of prematurity(ROP)is a disorder of retinal development in the low birthweight preterm infant.Eye screening is routinely performed for infants at risk of developing this disorder.While these examinations help prevent blindness,they can be physiologically stressful for infants,with changes in oxygen saturation,blood pressure and heart rate occurring during the exam and increased apneic episodes reported the 24-48 hours period afterward.The cause of these increased apneic episodes is not currently known.Our Background is to evaluate the effect of decreasing light simulation during mydriasis using an eye mask on the frequency of stressful episodes after ROP screening.Methods:Multi-centre randomized clinical study.This study was approved by hospital ethics boards at all sites.After informed consent was obtained,infants with a birthweight<1,500 g or gestational age of≤32 weeks and scheduled for their first ROP screening were randomized to receive either standard of care or a phototherapy mask during pupil dilation in addition to routine care.Dilated retinal exams were performed by retinal surgeons and fellows.The primary outcome was the frequency of any desaturation,bradycardic event,or apneic event 12 hours following the examination,compared to a baseline rate 12 hours prior to the exam.Heart rate,respiratory rate and oxygen saturation were recorded for up to 48 hours following the examination and compared to baseline.Results:A total of 51 infants were examined;28 randomized to the masked group and 23 to the control group.Ten and 13 infants were on ventilator support at the time of examination in each group,respectively.There was a 57.7%decrease in the total number of all stressful events in the masked group compared to controls in the 12-hour post exam period(rate ratio 0.42,95%CI,0.2-0.9,P=0.024).There was a 61.3%decrease in the number of bradycardic events in the masked group compared to controls(RR 0.39,95%CI,0.2-1.0,P=0.042).Heart rate was significantly higher in both groups after the exam(Mean HR:164.67 bpm post vs.157.3 bpm pre;P=0.04),with no difference in between groups(Effect by group P=0.31).There was no significant difference seen in either group in respiratory rate or oxygen saturation at 2 or 4 hours after the ROP examination compared to baseline.Risk factors that were associated with increased stress included younger gestational age(RR=1.3295%CI,1.2-1.5 per week),lower birthweight[RR=1.39(1.2-1.5)per 100 g],ventilator support around the time of exam[RR=2.67(1.3-5.6)],diagnosis of intraventricular hemorrhage[RR=3.78(1.9-7.3)],and hyponatremia[RR=3.42(1.8-6.6)].No adverse events occurred while using eye masks.Conclusions:The infants who wore a phototherapy mask during pupillary dilation had lower rates of stressful episodes following screening for retinopathy of prematurity,particularly lower episodes of bradycardia.展开更多
Retinal imaging is pivotal in the evaluation of ocular and systemic health,presenting significant promise for extensive popula-tion studies.However,the lack of standardized and automated techniques for extracting Imag...Retinal imaging is pivotal in the evaluation of ocular and systemic health,presenting significant promise for extensive popula-tion studies.However,the lack of standardized and automated techniques for extracting Imaging-Derived Phenotypes(IDPs)from retinal images is a major impediment.To counteract this challenge,the Chinese Human Phenome Project(CHPP)has developed a comprehensive protocol that includes Quality Control(QC),preprocessing,and automated or semi-automated extraction of IDPs from fundus photography and Optical Coherence Tomography(OCT)images.This protocol incorporates Artificial Intelligence(AI)-based methods to achieve accurate and efficient IDP extraction,facilitating standardized analysis of large-scale populations.We hope that this Standard Operating Procedure(SOP)guideline will impart valuable insights for ophthalmology-related disciplines and provides support for future research endeavors utilizing retinal imaging data.展开更多
Purpose:The advent of chatbots based on large language models(LLMs),such as ChatGPT,has significantly transformed knowledge acquisition.However,the application of LLMs in glaucoma patient education remains elusive.In ...Purpose:The advent of chatbots based on large language models(LLMs),such as ChatGPT,has significantly transformed knowledge acquisition.However,the application of LLMs in glaucoma patient education remains elusive.In this study,we comprehensively compared the performance of four common LLMs–Qwen,Baichuan 2,ChatGPT-4o,and PaLM 2–in the context of glaucoma patient education.Methods:Initially,senior ophthalmologists were asked with scoring responses generated by the LLMs,which were answers to the most frequent glaucoma-related questions posed by patients.The Chinese Readability Platform was employed to assess the recommended reading age and reading difficulty score of the four LLMs.Subsequently,optimized models were filtered,and 29 glaucoma patients participated in posing questions to the chatbots and scoring the answers within a real-world clinical setting.Attending ophthalmologists were also required to score the answers across five dimensions:correctness,completeness,readability,helpfulness,and safety.Patients,on the other hand,scored the answers based on three dimensions:satisfaction,readability,and helpfulness.Results:In the first stage,Baichuan 2 and ChatGPT-4o outperformed the other two models,though ChatGPT-4o had higher recommended reading age and reading difficulty scores.In the second stage,both Baichuan 2 and ChatGPT-4o demonstrated exceptional performance among patients and ophthalmologists,with no statistically significant differences observed.Conclusions:Our research identifies Baichuan 2 and ChatGPT-4o as prominent LLMs,offering viable options for glaucoma education.展开更多
AIM: To compare the effectiveness of postoperative adjunctive use of subconjunctival bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of intraocular pressure(IOP) and reduct...AIM: To compare the effectiveness of postoperative adjunctive use of subconjunctival bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of intraocular pressure(IOP) and reduction of postoperative bleb vascularization and fibrosis.METHODS: A prospective, one center, randomized, placebo-control study. Fifty-nine patients(59 eyes) with uncontrolled IOP under maximal tolerated medical treatment(MTMT) were recruited. A primary trabeculectomy with mitomycin C(MMC) was done and the patients were randomized to either postoperative subconjunctival injection of bevacizumab(1.25 mg/0.05 mL) or balanced salt solution(BSS). Forty-seven patients(47 eyes) completed at least one year of follow up and were included in the study. The main outcome measure was the IOP, and secondary outcome measures include bleb morphology, vascularization, and fibrosis, as well as the need for glaucoma medications and 5-fluorouracil(5-FU) needling.RESULTS: At 1-year follow up, there was no significant difference between groups for IOP(P=0.65), bleb morphology(P=0.65), and the need for glaucoma medications(P=0.65) or 5-FU needling requirements(P=0.11). However, the bevacizumab group had a higher rate of success results, lower use of glaucoma medications after surgery, and optimal bleb aspect in more patients, but more 5-FU needling procedures required. CONCLUSION: A bigger sample size is needed in order to determine whether the differences found in the bevacizumab group are statistically significant.展开更多
With the advent of microinvasive glaucoma surgery(MIGS),the spectrum of modalities available to manage patients with this chronic and heterogeneous condition has broadened.Despite its novelty however,there has been a ...With the advent of microinvasive glaucoma surgery(MIGS),the spectrum of modalities available to manage patients with this chronic and heterogeneous condition has broadened.Despite its novelty however,there has been a rapid evolution in the development of a multitude of devices,each targeting a structure along the aqueous drainage pathway.A growing body of evidence has demonstrated IOP and medication burden reduction,and a more favorable safety profile with MIGS procedures in contrast to traditional incisional surgeries.Among the array of MIGS,the Hydrus®Microstent(Ivantis,Inc.,Irvine,CA)is a recent FDA approved device,designed to bypass the trabecular meshwork and provide a scaffold for Schlemm’s canal.The objective of this article is to review the Hydrus from conception to clinical use,and present data on its efficacy and safety to date.The available literature has shown promise,however inherent to all novel devices,only longterm monitoring will ensure sustained IOP control and an acceptable safety profile.Surgical advancements in glaucoma have revolutionized the field,and continued research and development will establish these approaches in clinical treatment algorithms.展开更多
Dear Editor,We report a case of endogenous endophthalmitis(EE)secondary to Klebsiella pneumoniae(KP)liver abscess syndrome.EE is a severe infection of the vitreous cavity that results from the hematogenous spread of m...Dear Editor,We report a case of endogenous endophthalmitis(EE)secondary to Klebsiella pneumoniae(KP)liver abscess syndrome.EE is a severe infection of the vitreous cavity that results from the hematogenous spread of microorganism from a remote source into the eye;.展开更多
AIM： To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior,posterior and total corneal wavefront aberration.· METHODS： Steep meridian small incision phacoemulsi...AIM： To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior,posterior and total corneal wavefront aberration.· METHODS： Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site： 12 o＇clock, 9o＇clock and between 9 and 12 o＇clock（BENT） incision groups. The preoperative and 3-month postoperative root mean square（RMS） values of anterior, posterior and total corneal wavefront aberration including coma,spherical aberration, and total higher-order aberrations（HOAs）, were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented.·RESULTS： Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o＇clock incision group（P 〈0.001）. Corneal spherical aberration was statistically significantly lower after steep meridian small incision phacoemulsification cataract surgery in BENT incision group（P 〈0.05） and Pearson correlation analysisindicated that spherical aberration changes had no significant relationship with total astigmatism changes in all three corneal incision location.·CONCLUSION： Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration.The 12 o＇clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results.展开更多
文摘AIM:To assess early visual outcomes and corneal stability following small incision lenticule extraction(SMILE)in eyes with a pre-planned residual stromal thickness(RST)ranging from 280 to 300μm.METHODS:This retrospective study was designed to evaluate 82 eyes from 82 patients,all of whom had a pre-planned RST of 280 to 300μm and normal corneal topography prior to undergoing SMILE surgery.The mean preoperative spherical equivalent(SE)was-4.82±1.30 D.A standard follow-up protocol was conducted between 1 to 6mo postoperatively.Visual outcomes were recorded using uncorrected visual acuity(UCVA)and subjective refraction.The curvature of the anterior and posterior corneal surfaces,as well as the posterior elevation at the thinnest point(PTE)were derived from the Pentacam system.RESULTS:At the final follow-up,the efficacy index was 1.14±0.15,the safety index was 1.20±0.13.The mean preoperative UDVA was 0.78±0.16 logMAR,which improved significantly to-0.07±0.06 logMAR postoperatively(P<0.001).The preoperative mean SE was-4.82±1.30 D,which decreased to-0.14±0.30 D by the last visit.The curvature of the anterior cornea at the flat meridian(AK1)were 42.62±1.02 D preoperatively,38.56±1.37 D and 38.59±1.39 D at 1 and 6mo after operation,respectively.Corresponding measurements at the steep meridian(AK2)were 43.55±1.14 D preoperatively,39.18±1.46 D and 39.22±1.50 D at 1 and 6mo after operation,respectively.Both AK1 and AK2 remained stable at 1 and 6-mo postoperative intervals(P=0.126 and 0.082,respectively).There were no observed changes in the curvature of the posterior cornea at the flat meridian or at the steep meridian,or the PTE before and after surgery.CONCLUSION:SMILE represents a safe and effective procedure for the correction of myopia and astigmatism in eyes featuring a pre-planned RST ranging from 280 to 300μm accompanied by normal corneal topography,on the premise of strict control of surgical indications.
文摘AIM:To compare and evaluate the phacoemulsification parameters and postoperative endothelial cell changes of two different phacoemulsification machines, each with different modes, but also to assess the relationship between postoperative endothelial cell loss and the phacoemulsification parameters, as well as the other factors in both groups.METHODS:This prospective observational study was comprised of consecutive eligible cataract patients operated with phacoemulsification technique performed by the same surgeon using either a WHITESTAR Signature Ellips FX(transversal, group 1) or Infiniti OZil IP(torsional, group 2) machine.RESULTS:The study included 86 patients. Baseline characteristics in the groups were similar. The median nuclear sclerosis grade was 3(2-4) in the first group and2(2-4) in the second group(P =0.265). Both groups had similar phacoemulsification needle times(group 1: 60.63±36 s; group 2: 55.98±30 s; P =0.789). The percentage of endothelial cell loss 30 d after surgery ranged from 3% to15% with a median of 7% in group 1, and from 2% to13% with a median of 6% in group 2; however, there was no statistically significant difference between the groups(P =0.407). Hexagonality(P =0.794) and the coefficient of variation(CV; P =0.142) did not differ significantly between the groups before and 30 d after surgery. Asignificant positive correlation was found between the endothelial cell loss and nuclear sclerosis grade(group1: P 【0.001; group 2: P 【0.001) and between the endothelial cell loss and average phacoemulsification power(group 1: P =0.007; group 2: P =0.008).CONCLUSION:Both of these machines were efficient,with similar endothelial cell loss. This endothelial cell loss was related to the increased nuclear sclerosis grade and increased phacoemulsification power.
基金Supported by National Natural Science Foundation(No.81370992No.81570812)Research Foundation of Shanghai Science and Technology Committee(No.14411960600)
文摘AIM： To collect the evidence to estimate the correlation between smoking and the incidence of dry eye. METHODS： The Pub Med,EMBASE,the Cochrane Central Register of Controlled Trials（CENTRAL,last issue）,CBM（Chinese Bio Medical Literature Database）,and CNKI（China National Knowledge Infrastructure/Chinese Academic Journals full-text Database） were searched for eligible studies published from January1964 to December 2015 to investigate the association of smoking with the risk of dry eye.The odds ratio（OR）and 95% confidence interval（CI） were summarized and calculated.The extracted studies were pooled by the fixed-effects model or a random-effects model. RESULTS： Two cohort studies and eight cross-sectional surveys were included in our Meta-analysis.There was no statistically significant relationship between current（OR=1.32; 95% CI： 0.99-1.76; P=0.055）or ever smoking（OR=1.12; 95% CI： 0.98-1.28; P=0.107）and the risk of dry eye among the studies,even when age and gender were adjusted（OR=1.16; 95% CI： 0.83-1.64; P=0.383）.In the sensitivity analysis in which only general population were included,the association was significant between smoking and dry eye（OR=1.50; 95%CI： 1.08-2.09; P=0.016）.CONCLUSION： This Meta-analysis suggests that smoking may associate with the risk of dry eye in general population.
基金Supported by the National Natural Science Foundation of China(No.82171069No.82371070)+3 种基金Shanghai Science and Technology Committee(No.22015820200)Shanghai Municipal Health Commission Innovative Medical Device Application Demonstration Project(No.23SHS03500-03)Project of Shanghai Municipal Commission of Health and Family Planning(No.202140224)Grants from Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2021QN52).
文摘AIM:To characterize the N6-methyladenosine(m6A)modification patterns in long non-coding RNAs(lncRNAs)in sporadic congenital cataract(CC)and age-related cataract(ARC).METHODS:Anterior capsule of the lens were collected from patients with CC and ARC.Methylated RNA immunoprecipitation with next-generation sequencing and RNA sequencing were performed to identify m6A-tagged lncRNAs and lncRNAs expression.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses and Gene Ontology annotation were used to predict potential functions of the m6A-lncRNAs.RESULTS:Large amount of m6A peaks within lncRNA were identified for both CC and ARC,while the level was much higher in ARC(49870 peaks)than that in CC(18688 peaks),yet those difference between ARC in younger age group(ARC-1)and ARC in elder age group(ARC-2)was quite slight.A total of 1305 hypermethylated and 1178 hypomethylated lncRNAs,as well as 182 differential expressed lncRNAs were exhibited in ARC compared with CC.On the other hand,5893 hypermethylated and 5213 hypomethylated lncRNAs,as well as 155 significantly altered lncRNA were identified in ARC-2 compared with ARC-1.Altered lncRNAs in ARC were mainly associated with the organization and biogenesis of intracellular organelles,as well as nucleotide excision repair.CONCLUSION:Our results for the first time present an overview of the m6A methylomes of lncRNA in CC and ARC,providing a solid basis and uncovering a new insight to reveal the potential pathogenic mechanism of CC and ARC.
基金Supported by the National Key Research&Development Plan(No.2017YFC0108200)the Shanghai Committee of Science and Technology(No.16140901000+1 种基金 No.13430710500 No.15DZ1942204)
文摘AIM: To investigate changes in the rabbit retina after shortterm and small amounts tamponade of perfluorooctane(PFO).METHODS: New Zealand rabbits were used, and 48 eyes were randomly and evenly assigned into four different groups. The PFO groups received a residue of 0.1 mL of PFO for ophthalmic surgery or 0.1 mL of F-Octane at the end of surgery; eyes from the pars plana vitrectomy(PPV) group were filled with balanced salt solution and those having not received surgical intervention served as controls. Eyes were collected at 1, 4 and 12 wk and studied.RESULTS: Under a microscope, nuclear counts of the inner nuclear layer(INL) and outer nuclear layer(ONL) did not differ among the four groups at all time points; however, slight disarrangement of the ONL and occasional vacuolization of the INL were found in the inferior retina only at 12 wk in two PFO groups. Four of the groups had similar results of Caspase-3 and TNF-α staining at all time points. Alternatively, IL-8 was increased in PFOa and PPV control groups at 4 wk and in all three PPV groups at 12 wk; also, the apoptotic index(%) was similarly increased in all three PPV groups at 4 and 12 wk.CONCLUSION: Both PFOs are well tolerated in rabbit eyes for up to 12 wk, which suggests that they can be used safely as intraoperative tools or for short-term and small amounts tamponade after surgery.
基金Supported by the National Natural Science Foundation of China(No.82171093).
文摘AIM:To analyze ocular parameters and refractive status in children aged 3-12y and to explore differences in these parameters across age groups with identical refractive status for studying refractive progression.METHODS:Demographic characteristics,cycloplegic refraction data,and ocular parameters of the participants were collected.Changes in ocular parameters were described according to different age groups.After adjusting for refractive factors,the relationship between age and ocular parameters was explored.Standard regression coefficients(β)obtained from multiple linear regressions were used to compare the magnitude of the effect of age on the parameters and ocular components on refractive power.RESULTS:Data were collected from the right eyes of 1504 participants.Lens thickness(LT)decreased with age,whereas the axial length(AL)and anterior chamber depth(ACD)increased.In the high-hyperopia group,changes in age were only associated with AL and LT.In the low-myopia group,the increase in age was also associated with corneal astigmatism.In the overall model,theβvalue for LT was the highest at 0.41,whereasβfor ACD and AL was significant in all groups except for the high-hyperopia group.Theβvalue of the LT on refractive power in children was slightly greater in the low age group than in the high age group.CONCLUSION:Among children with the same refractive status,the older the age,the longer the axis length and the thinner the lens.The lens affected refractive power in children in the younger age group more than in the older age group.The ocular parameter most affected by age was LT.
基金Foundation of Health Science Research of the Health Bureau of Shanghai, China (No. 2008-161)Shi-Bai-Qian Plans of Jing'an district Health Bureau,Shanghai, China (No. 2010020103)
文摘AIM: To evaluate the efficacy of a registration system for the blind people and to monitor the blindness due to uncorrected refractive error and cataract in Jing’an district, Shanghai, China. ·METHODS: Five hundred and ten blind people, based on visual acuity screening in a population aged 70 or older were enrolled into the study. Four hundred and forty subjects were interviewed. The following data were collected on each patient: demographic data, number of hospital visits for eye related problems, distance visual acuity, visual fields, ophthalmic diagnoses, education and registration status. If the eligible subject was not registered as blind, the reason for non -registration was recorded. ·RESULTS: Ten point nine one percent blindness was due to cataract, 27.5% due to uncorrected refractive error, and only 61.59% met the eligible blindness criteria (uncorrected refractive error and cataract are not considered as eligible blindness). The first four leading causes of eligible blindness were age related macular degeneration (25.09% ), myopic macular degeneration (21.40%), glaucoma (18.82%) and corneal disease (8.12%). Only 68.27% eligible blind people were registered. The patients with macular degeneration and glaucoma tendednot to register. Blind people with an above primary school education were 2.59 times more likely to be registered than those who were illiterate or had only a primary school education (OR=2.59, 95%CI: 1.49-4.48, P 【0.01). Patients who had 4 or more visits to the hospital requesting eye care services in a year were 2.2 times more likely to be registered than those with less than 4 visits to the hospital (OR =2.54, 95% CI: 1.47 -4.38, P 【 0.001). The first two leading reasons of misregistration were unknowing the registration system (48% ) and unwilling to register (21%). ·CONCLUSION: Under-registration of the eligible blind people exists in the registry system. Education and the number of hospital visits for eye care services were factors associated with registration levels. Uncorrected refractive error and cataract are important causes of blindness.
基金supported by the Spanish Ministry of Economy and Competitiveness(PID2019-106498GB-I0)Instituto de Salud Carlos III,Fondo Europeo de Desarrollo Regional“Una manera de hacer Europa”(PI19/00071)+2 种基金Fundación Séneca,Agencia de Ciencia y Tecnología Región de Murcia(19881/GERM/15)Spanish Ministry of Science and Innovation(PID 2019-106498 GB-I00)Intramural Research Program of the National Eye Institute,National Institutes of Health(NIH/NEI RO1 EY029087)。
文摘Univocal identification of retinal ganglion cells(RGCs) is an essential prerequisite for studying their degeneration and neuroprotection. Before the advent of phenotypic markers, RGCs were normally identified using retrograde tracing of retinorecipient areas. This is an invasive technique, and its use is precluded in higher mammals such as monkeys. In the past decade, several RGC markers have been described. Here, we reviewed and analyzed the specificity of nine markers used to identify all or most RGCs, i.e., pan-RGC markers, in rats, mice, and macaques. The best markers in the three species in terms of specificity, proportion of RGCs labeled, and indicators of viability were BRN3A, expressed by vision-forming RGCs, and RBPMS, expressed by vision-and non-vision-forming RGCs. NEUN, often used to identify RGCs, was expressed by non-RGCs in the ganglion cell layer, and therefore was not RGC-specific. γ-SYN, TUJ1, and NF-L labeled the RGC axons, which impaired the detection of their somas in the central retina but would be good for studying RGC morphology. In rats, TUJ1 and NF-L were also expressed by non-RGCs. BM88, ERRβ,and PGP9.5 are rarely used as markers, but they identified most RGCs in the rats and macaques and ERRβ in mice. However, PGP9.5 was also expressed by non-RGCs in rats and macaques and BM88 and ERRβ were not suitable markers of viability.
文摘AIM： To evaluate human lens epithelium cell apoptosis and epithelial to mesenchymal transition （EMT） induced by femtosecond laser in femtosecond laser assisted cataract surgery （FLACS）. METHODS： Sixty cataract patients with N2 to N3 stage according to the LOCS III were enrolled in this study and divided into three groups randomly： FLACSl group （cataract surgery by FLACS with LenSx）, FLACS2 group （cataract surgery by FLACS with LensAR） and manual group （cataract surgery by phacoemulsification）. Patients in two FLACS groups performed anterior capsulotomy by LenSx or LensAR laser system. Patients in the manual group were performed continuous curvilinear capsulorrhexis （CCC） manually. The anterior capsules were fixed right after moved out of eye. Hematoxylin-eosine staining, immunofluorescence staining and real-time PCR were performed in order to observe human lens epithelium cells changes after cataract surgery. RESULTS： The capsule cutting edge was shown irregularity and roughness in two FLACS groups and smooth edge in manual capsulotomy by pathologic staining. Irregularities of the cell configuration with partly swollen and destroyed nuclei were observed in two FLACS groups. Femtosecond laser could induce a significantly higher cell apoptosis in human lens epithelium cell than manually performed CCC （P〈0.05）. Lens epithelium cells apoptosis were correlated with femtosecond laser duration according to Pearson correlation analysis. Decreased N-cadherin expression, alpha-SMA and FSP-1 level in two FLACS groups showed the inhibition of cell EMT. CONCLUSION： Femtosecond laser may affect the apoptosis and EMT of lens epithelium cells which are under the peeled central lens capsule.
基金Supported by National Natural Science Foundation of China(No.81700797)Science and Technology Commission of Shanghai Municipality(No.17411961800).
文摘AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazolin hydrochloride(NH)group(14 animals,14 eyes)and control group(14 animals,14 eyes).In CFA group,CFA was used in eyelid conjunctiva injection;in NH group,NH eye drops were used twice a day;control group was injected with equal dose of saline at the same time point and same site with animals in CFA group.The meibomian gland orifices score(MGOS)was evaluated on a scale of 0 to 3 in the middle five meibomian gland orifices of the upper and lower eyelid using slit lamp.After the successful induction of each animal model,intense pulsed light(IPL)was introduced on each mouse in CFA and NH group.Oil red O(ORO),hematoxylin and eosin(H&E)staining were performed before and after successful induction of CFA,NH and control group.RESULTS:At 12wk after CFA injection,inflammatory cell infiltration and fiber necrosis was observed,with acinar density and duct dilatation significantly lower compared with control group.In NH group,the meibomian gland acini were relatively smaller and deformed compared with control group,the number of meibomian gland acini was also slightly lower.No inflammatory cell or fiber necrosis was observed in NH group.After three times of IPL treatment(5/10 mice in each group,and the other 5 mice served as non-IPL control),MGOS was significantly lower in IPL-treated mice in NH group(P<0.01).After three times of IPL treatment,the MGOS of NH group was significantly lower than that in the CFA group(P<0.01).CONCLUSION:We develop a novel animal model that studies the role of inflammation in the development of MGD and IPL treatment.This model indicates that persistent inflammatory state may be the cause of MGD and weaken the therapeutic effect of IPL.
基金Supported by the National Natural Science Foundation of China(No.81770908)the Shanghai Science and Technology Commission(Scientific Innovation Project,No.20Y11911000)。
文摘AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.
基金Supported by research grants from the National Key R&D Program of China(No.2017YFC0108200)the Shanghai Committee of Science and Technology(No.16140901000+1 种基金 No.13430710500 No.15DZ1942204)
文摘AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coherence tomography in healthy Chinese adults. The horizontal scan of the right eye was used to measure the anterior chamber depth(ACD) at 199 points.RESULTS: A total of 309 images from 309 subjects were analyzed. The ACD values at nearly all locations were negatively correlated with age(all P<0.05), except for ACD1, 2, 198, and 199(correspond to the iris roots). The mean annual decrease 0.013±0.005 mm/y for all ACDs combined, 0.008±0.004 mm/y for the peripheral region, 0.017±0.003 mm/y for the middle peripheral region, and 0.014±0.001 mm/y for the central region. The mean annual decrease was significantly different among these three regions(P<0.001). The ACD was greater in males than in females(P<0.05). The mean difference in ACD between males and females was 0.081±0.025 mm.CONCLUSION: This study showed that optical coherence tomography can be used to measure the ACD of different regions of the AC. We found reductions in ACD with age, although the reduction varied among different points, in healthy Chinese adults.
文摘Background:Esotropia is a common concern in pediatric ophthalmology consultations.While most cases stem from strabismus,it is crucial for physicians to differentiate atypical features that might indicate underlying organic causes,such as VI nerve palsy,hinting at the presence of intracranial spaceoccupying lesions.Although the occurrence of cerebral aneurysms in children is rare,they can have severe consequences.Case Description:Here,we described an extremely rare case of giant basilar fusiform aneurysm measuring 4.0 cm×3.9 cm×3.9 cm in an otherwise healthy 8-year-old child,and analyzed its atypical features that suggested an intracranial etiology.We further described an endovascular approach,performed by interventional radiologists,and discussed its advantages over the conventional neurosurgery.The patient continued to be followed by our multidisciplinary team.He had a stable post-operative course and made an excellent recovery neurologically.At the 1-year follow-up,he was orthophoria with excellent vision and stereopsis.Conclusions:To our knowledge,this is the first pediatric case in Canada where a giant intracranial aneurysm was treated endovascularly.The salient red flags—progressive incomitant esotropia and diplopia,the presence of myopia(rather than hyperopia),nystagmus and abnormal saccadic movements—should be astutely recognized by clinicians as intracranial giant aneurysms carry a poor prognosis.A multidisciplinary approach is essential for the management of such cases.
文摘Background:Retinopathy of prematurity(ROP)is a disorder of retinal development in the low birthweight preterm infant.Eye screening is routinely performed for infants at risk of developing this disorder.While these examinations help prevent blindness,they can be physiologically stressful for infants,with changes in oxygen saturation,blood pressure and heart rate occurring during the exam and increased apneic episodes reported the 24-48 hours period afterward.The cause of these increased apneic episodes is not currently known.Our Background is to evaluate the effect of decreasing light simulation during mydriasis using an eye mask on the frequency of stressful episodes after ROP screening.Methods:Multi-centre randomized clinical study.This study was approved by hospital ethics boards at all sites.After informed consent was obtained,infants with a birthweight<1,500 g or gestational age of≤32 weeks and scheduled for their first ROP screening were randomized to receive either standard of care or a phototherapy mask during pupil dilation in addition to routine care.Dilated retinal exams were performed by retinal surgeons and fellows.The primary outcome was the frequency of any desaturation,bradycardic event,or apneic event 12 hours following the examination,compared to a baseline rate 12 hours prior to the exam.Heart rate,respiratory rate and oxygen saturation were recorded for up to 48 hours following the examination and compared to baseline.Results:A total of 51 infants were examined;28 randomized to the masked group and 23 to the control group.Ten and 13 infants were on ventilator support at the time of examination in each group,respectively.There was a 57.7%decrease in the total number of all stressful events in the masked group compared to controls in the 12-hour post exam period(rate ratio 0.42,95%CI,0.2-0.9,P=0.024).There was a 61.3%decrease in the number of bradycardic events in the masked group compared to controls(RR 0.39,95%CI,0.2-1.0,P=0.042).Heart rate was significantly higher in both groups after the exam(Mean HR:164.67 bpm post vs.157.3 bpm pre;P=0.04),with no difference in between groups(Effect by group P=0.31).There was no significant difference seen in either group in respiratory rate or oxygen saturation at 2 or 4 hours after the ROP examination compared to baseline.Risk factors that were associated with increased stress included younger gestational age(RR=1.3295%CI,1.2-1.5 per week),lower birthweight[RR=1.39(1.2-1.5)per 100 g],ventilator support around the time of exam[RR=2.67(1.3-5.6)],diagnosis of intraventricular hemorrhage[RR=3.78(1.9-7.3)],and hyponatremia[RR=3.42(1.8-6.6)].No adverse events occurred while using eye masks.Conclusions:The infants who wore a phototherapy mask during pupillary dilation had lower rates of stressful episodes following screening for retinopathy of prematurity,particularly lower episodes of bradycardia.
基金funded by the Shanghai Municipal Science and Technology Major Project(No.2017SHZDZX01).
文摘Retinal imaging is pivotal in the evaluation of ocular and systemic health,presenting significant promise for extensive popula-tion studies.However,the lack of standardized and automated techniques for extracting Imaging-Derived Phenotypes(IDPs)from retinal images is a major impediment.To counteract this challenge,the Chinese Human Phenome Project(CHPP)has developed a comprehensive protocol that includes Quality Control(QC),preprocessing,and automated or semi-automated extraction of IDPs from fundus photography and Optical Coherence Tomography(OCT)images.This protocol incorporates Artificial Intelligence(AI)-based methods to achieve accurate and efficient IDP extraction,facilitating standardized analysis of large-scale populations.We hope that this Standard Operating Procedure(SOP)guideline will impart valuable insights for ophthalmology-related disciplines and provides support for future research endeavors utilizing retinal imaging data.
基金supported by National Science Fund for Distinguished Young Scholars(82425015)National Natural Science Foundation of China(82171102)+3 种基金National youth talent support program(QWF158001)National Key Research and Development Program of China(2023YFA0915000)Shanghai Medical Innovation Research Program(22Y21900900)of J.HNational Natural Science Foundation of China(82271044)of X.Z.
文摘Purpose:The advent of chatbots based on large language models(LLMs),such as ChatGPT,has significantly transformed knowledge acquisition.However,the application of LLMs in glaucoma patient education remains elusive.In this study,we comprehensively compared the performance of four common LLMs–Qwen,Baichuan 2,ChatGPT-4o,and PaLM 2–in the context of glaucoma patient education.Methods:Initially,senior ophthalmologists were asked with scoring responses generated by the LLMs,which were answers to the most frequent glaucoma-related questions posed by patients.The Chinese Readability Platform was employed to assess the recommended reading age and reading difficulty score of the four LLMs.Subsequently,optimized models were filtered,and 29 glaucoma patients participated in posing questions to the chatbots and scoring the answers within a real-world clinical setting.Attending ophthalmologists were also required to score the answers across five dimensions:correctness,completeness,readability,helpfulness,and safety.Patients,on the other hand,scored the answers based on three dimensions:satisfaction,readability,and helpfulness.Results:In the first stage,Baichuan 2 and ChatGPT-4o outperformed the other two models,though ChatGPT-4o had higher recommended reading age and reading difficulty scores.In the second stage,both Baichuan 2 and ChatGPT-4o demonstrated exceptional performance among patients and ophthalmologists,with no statistically significant differences observed.Conclusions:Our research identifies Baichuan 2 and ChatGPT-4o as prominent LLMs,offering viable options for glaucoma education.
基金Supported by the Glaucoma Research Society of Canada
文摘AIM: To compare the effectiveness of postoperative adjunctive use of subconjunctival bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of intraocular pressure(IOP) and reduction of postoperative bleb vascularization and fibrosis.METHODS: A prospective, one center, randomized, placebo-control study. Fifty-nine patients(59 eyes) with uncontrolled IOP under maximal tolerated medical treatment(MTMT) were recruited. A primary trabeculectomy with mitomycin C(MMC) was done and the patients were randomized to either postoperative subconjunctival injection of bevacizumab(1.25 mg/0.05 mL) or balanced salt solution(BSS). Forty-seven patients(47 eyes) completed at least one year of follow up and were included in the study. The main outcome measure was the IOP, and secondary outcome measures include bleb morphology, vascularization, and fibrosis, as well as the need for glaucoma medications and 5-fluorouracil(5-FU) needling.RESULTS: At 1-year follow up, there was no significant difference between groups for IOP(P=0.65), bleb morphology(P=0.65), and the need for glaucoma medications(P=0.65) or 5-FU needling requirements(P=0.11). However, the bevacizumab group had a higher rate of success results, lower use of glaucoma medications after surgery, and optimal bleb aspect in more patients, but more 5-FU needling procedures required. CONCLUSION: A bigger sample size is needed in order to determine whether the differences found in the bevacizumab group are statistically significant.
基金support for the research,authorship,and/or publication of this article:this study was supported by Ivantis,Inc.,(Irvine,CA).
文摘With the advent of microinvasive glaucoma surgery(MIGS),the spectrum of modalities available to manage patients with this chronic and heterogeneous condition has broadened.Despite its novelty however,there has been a rapid evolution in the development of a multitude of devices,each targeting a structure along the aqueous drainage pathway.A growing body of evidence has demonstrated IOP and medication burden reduction,and a more favorable safety profile with MIGS procedures in contrast to traditional incisional surgeries.Among the array of MIGS,the Hydrus®Microstent(Ivantis,Inc.,Irvine,CA)is a recent FDA approved device,designed to bypass the trabecular meshwork and provide a scaffold for Schlemm’s canal.The objective of this article is to review the Hydrus from conception to clinical use,and present data on its efficacy and safety to date.The available literature has shown promise,however inherent to all novel devices,only longterm monitoring will ensure sustained IOP control and an acceptable safety profile.Surgical advancements in glaucoma have revolutionized the field,and continued research and development will establish these approaches in clinical treatment algorithms.
文摘Dear Editor,We report a case of endogenous endophthalmitis(EE)secondary to Klebsiella pneumoniae(KP)liver abscess syndrome.EE is a severe infection of the vitreous cavity that results from the hematogenous spread of microorganism from a remote source into the eye;.
文摘AIM： To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior,posterior and total corneal wavefront aberration.· METHODS： Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site： 12 o＇clock, 9o＇clock and between 9 and 12 o＇clock（BENT） incision groups. The preoperative and 3-month postoperative root mean square（RMS） values of anterior, posterior and total corneal wavefront aberration including coma,spherical aberration, and total higher-order aberrations（HOAs）, were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented.·RESULTS： Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o＇clock incision group（P 〈0.001）. Corneal spherical aberration was statistically significantly lower after steep meridian small incision phacoemulsification cataract surgery in BENT incision group（P 〈0.05） and Pearson correlation analysisindicated that spherical aberration changes had no significant relationship with total astigmatism changes in all three corneal incision location.·CONCLUSION： Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration.The 12 o＇clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results.
